EP24.12: Management of Caesarean scar pregnancy: towards a new protocol

Abstract

To show the importance of ultrasonography in the diagnosis and monitoring of Caesarean scar pregnancy and to assess the value of in situ injection of methotrexate in its management. Data from all medical files with the diagnosis of Caesarean scar pregnancy, between 2013 and 2016, were retrospectively collected. We brought together the clinical signs of appeal, the detailed ultrasound signs having allowed to hold the diagnosis. After in situ injection of methotrexate, monitoring was done by HCG plasma levels and transvaginal ultrasound. The deadline of the ultrasound disappearance of the gestational ectopic sacs after in situ treatment was reported. We collected 12 cases. The average age of our patients was 31.5 years. The mean gestational age was 7 weeks of amenorrhea. The chief complaint was bleeding irregularities associated in 66.7% of cases with pelvic pain. Transvaginal ultrasound succeeded to diagnose all cases. All patients were treated with in situ injection of methotrexate performing a vaginal way and required a second injection because of the stagnation or the rise of HCG levels. The average time for negativity plasma HCG was 63 days. Supporting information can be found in the online version of this abstract Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.